Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $162.18	Facility		$107.15	$107.15	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $371.54	Professional		$107.15	$131.83	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $125.89 / $138.04	Professional		$114.82	$125.89	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $134.90	Professional		$97.72	$117.49	$134.90
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $208.93	Professional		$131.83	$158.49	$208.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $123.03	Facility		$114.82	$114.82	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $295.12	Professional		$123.03	$169.82	$295.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $147.91 / $295.12	Facility		$107.15	$147.91	$295.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $295.12	Professional		$107.15	$131.83	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $154.88	Professional		$32.36	$33.11	$154.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $269.15	Professional		$120.23	$213.80	$269.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $162.18 / $295.12	Facility		$109.65	$162.18	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $323.59	Professional		$120.23	$169.82	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $218.78	Professional		$112.20	$147.91	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $141.25	Professional		$91.20	$117.49	$141.25